Testing Of Vestibular Function By Active Head Movements.
Funder
National Health and Medical Research Council
Funding Amount
$180,509.00
Summary
The vestibular system of the inner ear is responsible for our sense of balance and for maintaining clear vision and stable posture during head movements. This complex interdependent sensory system is comprised of three paired semicircular canals for sensing head rotations and two paired otolith organs for sensing head position and linear movements of the head. A major goal of our research programs is to develop simple tests which can be used in the clinic or at the bedside to diagnose specific d ....The vestibular system of the inner ear is responsible for our sense of balance and for maintaining clear vision and stable posture during head movements. This complex interdependent sensory system is comprised of three paired semicircular canals for sensing head rotations and two paired otolith organs for sensing head position and linear movements of the head. A major goal of our research programs is to develop simple tests which can be used in the clinic or at the bedside to diagnose specific deficits of each vestibular sensory region. Most present clinical tests only test the part of the system concerned with horizontal head rotations but there are many other sensory regions in the inner ear whose functional status needs to be evaluated, especially those regions concerned with signalling linear head movements and head position - the otolith sensory regions. The usual principle in vestibular testing is to move the person's head and measure the eye movement which occurs in response to that passive movement. One of our recent observations suggest that it may be possible to measure vestibular functioning during active head movements. Active testing does not require expensive, invasive testing systems and could be carried out in the clinic. This project will compare the eye movement response to active and passive head movements in the same patients. We will test both the angular and linear sensing systems by asking patients to rotate their head or slide it laterally, recording the head movement stimulus and eye movement response. Two groups of patients will be studied; those who have recovered well and those who are poorly recovered after unilateral vestibular loss. The outcome will, we hope, be safe simple low cost tests which will evaluate the functional status of all the inner ear sensory regions and yet be clinically practical. They may provide the answer as to why some patients do not recover well after unilateral loss whereas others do.Read moreRead less
Behavioural And Physiological Tests Of Clinical Indicators Of Vestibular Function.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Part of the inner ear is responsible for our sense of balance and for maintaining clear vision and stable posture. Recurring vertigo attacks and persistent imbalance can disrupt the most productive years of patients' lives and balance-related falls account for more the half of accidental deaths in the elderly. Despite this most doctors find dizziness difficult to diagnose and impossible to treat, so specialist Balance Disorders Clinics see many patients a year but still have very long waiting ti ....Part of the inner ear is responsible for our sense of balance and for maintaining clear vision and stable posture. Recurring vertigo attacks and persistent imbalance can disrupt the most productive years of patients' lives and balance-related falls account for more the half of accidental deaths in the elderly. Despite this most doctors find dizziness difficult to diagnose and impossible to treat, so specialist Balance Disorders Clinics see many patients a year but still have very long waiting times. There is then clearly a major need to improve the understanding and the treatment of dizzy patients and improvement will come about through scientific understanding of vestibular dysfunction, and technological realization of improvements in the assessment and treatment of patients. This project seeks to identify whether 3 simple new indicators of balance function are valid, using tests on guinea pigs to understand the way in which they work.Read moreRead less
Vestibulo-ocular Responses To Bone Conducted Vibration
Funder
National Health and Medical Research Council
Funding Amount
$282,772.00
Summary
This project is about an entirely new way of clinically evaluating balance function of the inner ear by using bone conducted vibration (BCV). We will make measures of the BCV stimulus in order to specify the stimulus at the receptors, and relate this stimulus to the eye-movement responses it causes. Measuring the exact stimulus and the response will give us a much better understanding of why this stimulus works, allowing us to optimize the clinical tests of balance function.
The Neural Basis Of Clinical Vestibular Testing By Bone Conducted Sound
Funder
National Health and Medical Research Council
Funding Amount
$260,986.00
Summary
Dysfunction of the balance system of the inner ear (the vestibular system) causes recurring dizzy attacks and persistent unsteadiness which can disrupt the most productive years of some people's lives. Balance-related falls account for more than half of accidental deaths in the elderly (Marchetti and Whitney 2005). Despite this, most doctors find dizziness difficult to diagnose and almost impossible to treat in part because of the subjective nature of the patients' reports. Fast, simple, safe, o ....Dysfunction of the balance system of the inner ear (the vestibular system) causes recurring dizzy attacks and persistent unsteadiness which can disrupt the most productive years of some people's lives. Balance-related falls account for more than half of accidental deaths in the elderly (Marchetti and Whitney 2005). Despite this, most doctors find dizziness difficult to diagnose and almost impossible to treat in part because of the subjective nature of the patients' reports. Fast, simple, safe, objective clinical tests are needed to diagnose these patients' problems and to identify which of the 10 vestibular sensory regions is affected. A new way of testing balance function is to use sound because sound can activate the vestibular system as well as the auditory system. We are using that fact to develop a whole new way of clinical testing of vestibular function and this largely Australian development has been very rapidly accepted by the international vestibular community. In a recent NHMRC project (253620) we discovered 1) that bone conducted vibration specifically activates some sensory nerves from one of the gravity sensing regions of the balance system (the otoliths) and 2) that air-conducted (AC) sound and bone-conducted vibration (BCV) appear to probe the function of different vestibular sensory regions 3) most importantly that BCV causes an eye movement response in alert guinea pigs (as it does in alert human subjects). This seems to be the objective response for testing otolith function which we are seeking. In this project we plan to extend these results by recording single vestibular nerve cells in guinea pigs, testing hypotheses about their responses to various types of sound and then injecting the neurons with stains which will allow us to confirm definitely the location of the receptors activated by the sound stimuli. The outcome will be the physiological basis of a new clinical test of balance using bone conducted vibration.Read moreRead less
Oculomotor Tests Of Otolith Function Using Human Centrifugation
Funder
National Health and Medical Research Council
Funding Amount
$284,450.00
Summary
The effects of dysfunction of the balance system of the inner ear (the vestibular system) can range from mild brief episodes of dizziness to almost complete incapacitation: where the patient feels unstable, their posture is unstable, their vision is unstable. In order to guide appropriate treatment and rehabilitation, diagnostic tests are needed to identify whether the dysfunction is due to a brain problem or a problem in the inner ear, and if an ear problem - which part of the inner ear system ....The effects of dysfunction of the balance system of the inner ear (the vestibular system) can range from mild brief episodes of dizziness to almost complete incapacitation: where the patient feels unstable, their posture is unstable, their vision is unstable. In order to guide appropriate treatment and rehabilitation, diagnostic tests are needed to identify whether the dysfunction is due to a brain problem or a problem in the inner ear, and if an ear problem - which part of the inner ear system is affected. By combining basic research with clinically feasible methods my colleagues and I have, with NH and MRC support, developed some of the most widely used clinical tests of balance function available today (see Halmagyi, Cremer and Curthoys 2003 for a review). In this Project I seek to continue the development of a test of part of the balance system (the utricular macula) for which there are few acceptable tests. I will do that by using the unique facilities available at Sydney University and RPA Hospital, presenting controlled stimuli (linear accelerations) to healthy human subjects and patients with known vestibular losses, and measuring precisely their eye movement responses to these stimuli using computerized image processing techniques. The experiments will test an hypothesis about how part of the vestibular system, the utricular macula, works and controls eye movements. One eye movement response, rolling of the eye around the line of sight (called ocular torsion) during maintained roll head-tilts (to the patients left or right) may be due to the joint activation of two regions of the balance receptors: the utricular and saccular maculae. As a result of a recent direct test we have managed to conduct on two normal subjects, we think that hypothesis should be thoroughly re-tested on subjects and patients with known vestibular losses and in doing so provide new understanding of otolith function which may lead to new clinical tests.Read moreRead less
Vestibular Reflexes Evoked By Brief Lateral Head Acclerations: A New Measure Of Utricular Function
Funder
National Health and Medical Research Council
Funding Amount
$225,357.00
Summary
The vestibular (balance) organs are difficult to investigate as they lie deep within bone. Disease of these organs may cause severe vertigo, imbalance and difficulty with vision. This project attempts to build on earlier developments in my laboratory and thereby improve understanding and diagnosis of these disorders. This grant relates to a new form of stimulation which may allow simple assessment of an important part of the vestibular apapratus, the utricle.
I am a neuroscientist specializing in human balance disorders. Over the past 17 years my research has focused on developing innovative, objective and accessible measurements of semicircular canal and otolith function of the vestibular system in three dime
Experimental Validation Of A Clinical Indicator Of Utricular Function.
Funder
National Health and Medical Research Council
Funding Amount
$198,689.00
Summary
The vestibular system is responsible for our sense of balance, it is located in the inner ear and is responsible for maintaining posture and helping an organism to make appropriate eye movements when the head moves. Damage to the vestibular system by disease or accident is extremely debilitating for a patient. A chief goal of our research program is to develop simple tests of the vestibular system that can be used in the clinic to diagnose vestibular disorders. Most present clinical tests only t ....The vestibular system is responsible for our sense of balance, it is located in the inner ear and is responsible for maintaining posture and helping an organism to make appropriate eye movements when the head moves. Damage to the vestibular system by disease or accident is extremely debilitating for a patient. A chief goal of our research program is to develop simple tests of the vestibular system that can be used in the clinic to diagnose vestibular disorders. Most present clinical tests only test the part of the vestibular system that responds to angular rotations (the semicircular canals). There are few good tests that can reliably diagnose problems concerned with sensed position (the otoliths). Recent evidence from human studies has shown that by delivering small electrical currents (galvanic stimulation) via electrodes located on the surface of the skin behind the ears, a characteristic pattern of eye movement occurs. Our hypothesis is that the distinctive pattern of eye movement produced is a result of otolith stimulation. The aim of this project is to determine exactly how these small currents produce the eye movements and if these eye movements are in fact mediated by the otoliths. To determine the physiology that underlies these types of responses we are unable to conduct these experiments in humans. Our present program will therefore use both behavioural and physiological experiments on guinea pigs to test our hypotheses about galvanic stimulation and otolith function. The significance of this work lies in that it will lead to a new way of evaluating the function of the gravity sensing part of the human vestibular system which appear to be uniquely important for patients with balance problems.Read moreRead less
Gentamicin Vestibulotoxicity: Detection And Prevention
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
A powerful, life-saving and cheap antibiotic, gentamicin, has one potential serious permanent side-effect: loss of balance due to damage to the balance organs of the inner ears. Detected early, the inner ear damage can be reversed by stopping gentamicin. Until now there has been no way of monitoring inner ear balance at the bedside. We have now developed such a method and want to show that by monitoring inner ear balance of patients needing gentamicin we can detect damage at such an early stage ....A powerful, life-saving and cheap antibiotic, gentamicin, has one potential serious permanent side-effect: loss of balance due to damage to the balance organs of the inner ears. Detected early, the inner ear damage can be reversed by stopping gentamicin. Until now there has been no way of monitoring inner ear balance at the bedside. We have now developed such a method and want to show that by monitoring inner ear balance of patients needing gentamicin we can detect damage at such an early stage that stopping the drug and using another instead will allow the balance organs to recover by themselves.Read moreRead less
The Vestibulo-collic Reflex In Humans And Its Use In Diagnosis Of Vertigo
Funder
National Health and Medical Research Council
Funding Amount
$278,691.00
Summary
This project will investigate the vestibulo-collic reflex (VCR): a head-stabilising reflex of the neck muscles. The VCR plays an important role in human balance, but is not well-understood. A form of the reflex is used to test vestibular (balance) function in patients with dizziness and vertigo, however the accuracy and interpretation of the test as it is currently used is not optimal. This project aims to improve the accuracy of the VCR in the diagnosis of balance disorders.